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The Definition and Usage of Procedure Code D7250

There is some confusion over the definition and usage of procedure code D7250, especially by general practitioners. The American Dental Association’s CDT manual defines code D7250 as “Surgical removal of residual roots (cutting procedure), includes cutting of soft tissue and bone, removal of tooth structure and closure.”

“Residual roots” do not represent a current extraction of a tooth, but root remnants left from a previous extraction. If such roots exist, then a surgical flap, removal of bone, and removal of the root remnants should be accomplished and noted on the clinical record.

If the crown of the tooth has been fractured or destroyed by caries, and the removal of the exposed root is elevated and/or removed with forceps—even if a periosteal flap is completed—the appropriate ADA code is D7140, extraction, erupted tooth or exposed root (elevation and forceps removal). If, in addition to the flap, bone is removed, or the roots are sectioned in order to remove the roots, then the surgical extraction code is D7210.

The consultants would like to pass along some other helpful hints to avoid delay in processing your claims. These are commonly submitted items that cause the claims to suspend for review.

The patient’s full given name should be indicated on the claim, not a nickname, such as: Robert not Bob; William not Bill; Pamela not Pam; Nathan not Nate, etc.

Please be sure to use the patient’s correct date of birth.

Both dentists and insurance carriers must use the most current ADA procedure codes when submitting and processing claims.

Please indicate a tooth number or quadrant when filing a claim for palliative treatment, procedure code D9110.

Submitting a line item with $0.00 fee will cause the claim to suspend. Our claims processors must then manually remove the line from the claim.

If you have any questions, please call Professional Relations at 1-800-537-1715, and ask to speak to one of the consultants.